Friday, October 16, 2009

The Vancouver Island Health Authority's plan to deal with provincial underfunding is a destructive mishmash of measures that hurt patients, increase long-term costs and ignore real health issues.And it's a pattern occurring across the province as all the regional health authorities struggle to find $360 million in spending cuts.Fewer surgeries and diagnostic tests, cuts to care for seniors and the addicted, reduced community programs - VIHA revealed a list of measures that reduce the level of care in the region.The problem is simple. The health authority's funding from the provincial government, despite a 5.9-per-cent increase, is $45 million short of what's needed to provide care to residents. VIHA proposes service cuts, higher fees and property sales to deal with the lack of money from the province.The other health authorities face the same crunch and have announced, or soon will reveal, similar cuts.The timing is ridiculous. VIHA's fiscal year started last March 31, like the other health authorities. It is only now, more than halfway through the year, revealing plans to address a $45-million shortfall it knew about nine months ago. That's not competent. Practically, it means cuts need to be deeper. Instead of 12 months of savings, the authority needs to find the same money in five months.Politically, it means people voted in May without knowing the effects of Liberal policies. The cuts reflect a choice by the Campbell government to limit health-care funding; the consequences were never made clear in the election campaign. Quite the contrary. Premier Gordon Campbell promised that despite financial pressures, core services like health would be protected. The authority knew in February cuts were needed; so did the Liberals. Only in October did they reveal the reality.VIHA will cut the number of surgeries by 1.3 per cent. Fewer operations means longer waits for suffering people, some unable to work or care for their children. It has reduced the number of MRIs and closed mental health beds.Those are cuts to services. That's a Liberal promise - an important one - broken. The other major problem is that the cuts are desperate and short term. They don't really save money.Cutting the number of operations just means that more will be needed next year. Making people wait means more emergency room visits, more pain drugs and worse outcomes. It's a straightforward equation. About 30 people a month in the capital region are told they need non-urgent hip replacement. It's called elective surgery, but it's not. No one is going to let doctors cut away their hip bones unless it's desperately needed to stop pain and restore mobility.If system provided 30 operations, the wait would remain the same. But if it provided 25 operations, then five people would be bumped to the next month. By the end of the year, 60 people would be parked on the waiting list. And each year, the wait would grow longer. The health authority is also cutting grants to community organizations that deliver front-line services. That too is a short-term saving with long-term costs. Victoria Citizens' Counselling, for example, provides help for more than 1,000 people annually, mainly working poor and those on income assistance. Demand has increased by 25 per cent in the past 12 months. VIHA has eliminated its funding, which was 30 per cent of the budget.The health authority is also selling real estate and privatizing care homes. Publicly operated seniors' homes will be closed and the property sold to corporate providers. The authority will pay for spaces for seniors needing residential care.Leave aside the public-private debate. The health authority is selling assets - a one-time gain - and using the money to cover operating deficits.Next year, based on the three-year budget, the funding shortfall will be just as great. The money from selling real estate will be gone. And the cuts to health care will need to be much deeper. The year after that, more of the same.It's cruel to make people wait for care or treatment without at least discussing whether it makes more sense to look after them promptly. It's dishonest for the government have promised to protect services during the election campaign.And it's foolish to think that pushing costs into the future is any real solution.

Thursday, October 15, 2009

I've just been helping mount some of the art for this event. It's quite powerful; you've got to see it.Art and Soul is part of Homelessness Action Week, billed as "a special evening featuring the art and music of people who have experience homelessness."It's a casual event at the Victoria Conservatory of Music building - 907 Pandora - to celebrate the creativity and talent of local artists you probably don't know. It's on from 7 to 10, Saturday, Oct. 17.Admission is free. You can meet the artists and hear music by people who have known homelessness. Some works will be for sale. They'll be snacks and a little beer. As well as the artists' works, Rev. Al Tysick has loaned some works from his collection. And there will be a slide show of the work of the late Hans Fear, a great talent.OK, my partner is organizing the event. But really, you should see the pictures.

Tuesday, October 13, 2009

Things have been changing in B.C. since the election, for the worse.The cuts in services and community supports and the tax breaks for businesses represent a big shift in the kind of province we're handing on to our children.These aren't just the usual post-election initiatives, but changes that reflect a dramatic change in values. The recession would inevitably have forced some changes on any government. But increasingly, it looks like what's really underway is a search and destroy mission aimed at programs and services that had been considered important.These programs had all survived the Liberals' first term core review to strip government down to its essential roles. The cuts are brutal and poorly thought out. Solicitor General Kash Heed said he didn't know that cutting $440,000 from frontline support for victims of domestic violence would be a problem. Premier Gordon Campbell didn't understand gaming grant cuts reneged on three-year commitments to charities. Both were reversed as a result of public pressure.Hundreds of others are going ahead. Less help for autistic children, halving of support for school parent advisory committees, longer waits for health care, no repairs to leaky schools, cuts to kids sports, reduced treatment for drug addicts. The list is long. And the loss is likely permanent. Grants to parent advisory councils can be restored before the next election, of course. But if a treatment centre has closed because funding was cut, then the resource is lost.This goes beyond a trimming of programs. The Liberals seem to be making a structural and cultural change. The people hurt by the cuts have overwhelmingly been the already disadvantaged - children with disabilities or struggling schools or people who couldn't afford private health care. Local seniors' drop-in centres or libraries.Cumulatively, the cuts change who we are. Over decades, British Columbians have come to set out a collective role in helping people who needed it, and the limits of that support. Now, we have decided we will do much less. Those affected will have to accept their diminished lives.That's a choice a society can make.But British Columbians didn't get a chance to make that choice. Gordon Campbell ran his spring election campaign on the promise that big cuts weren't needed in B.C.And then proceeded to make them.These aren't temporary cuts during a recession. In fact, they are just the beginning.Non-health spending, after a small increase this year, is to be cut in each of the next two years. This funding isn't going to be restored. (Health spending rises by about six per cent annually in the current three-year plan.)At the same time, the government is shifting the burden of paying for the remaining services from large businesses to individual taxpayers. The harmonized sales tax, according to Campbell, will reduce the taxes paid by businesses by $1.9 billion a year. It will also be revenue neutral, he said. The government won't be out any money. Which means individuals will see their taxes increase to cover that shift. (Some businesses will pay more too, like restaurants. The Finance Ministry has been unable to provide any numbers on the share of the burden between the unlucky businesses and individuals.) Again, society can make a choice to tax business less and individual families more. Lower business taxes can attract investment. Jobs are created, competition for employees raises wages and most people get enough money to pay the higher taxes, plus a bit. (Probably not the most disadvantaged, who depended on those services.) But again, the Liberals didn't campaign on the need to reduce the tax burden on big business by raising it on everyone else. In fact, they specifically ruled out the HST.Big, lasting changes are underway in B.C. And the people have never had a chance to say whether they approve. Footnote: The Liberals have faltered in explaining or defending the cuts in the legislature and their support has plummeted since the election, according to the polls. The impact of the cuts and the HST, which takes effect July 1, will continue past the midpoint of the Campbell government's term.